ESTRO 2021 Abstract Book

S455

ESTRO 2021

[3] Meijers et al., 2020, Radiother. Oncol. 150, 268-274

SP-0583 4D imaging and online motion management A. Knopf 1 1 University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Cologne, Cologne, Germany Abstract Text In this talk, we will review the current understanding of 4D challenges for scanned proton therapy. A clinical workflow for the treatment of moving indications with scanned proton therapy using 4D dose reconstruction & accumulation will be introduced and the future potential for real-time adaptation considering daily images and a high degree of automatization will be discussed.

SP-0584 Towards MR-integrated proton therapy B. Oborn 1 1 University of Wollongong, Centre for Medical Radiation Physics, Wollongong, Australia

Abstract Text Image guidance in radiotherapy has been an integral component in its evolution and continued success. Starting from 2004, we witnessed a decade of evolution of integrated real-time MRI-guided x-ray therapy from simulations to a fully operational clinical system in 2014[1]. At present 2 clinical systems[1,2] are continuing to treat patients with a third system approved for treatments[3]. A 4 th pre-clinical system exists as well[4]. The success of these x-ray based systems naturally prompted the community to consider the feasibility of MRI guidance for proton beam therapy. MR-guidance for particle therapy can be implemented in at least three different approaches; near-room MRI, in-room MRI, in-beam MRI or real-time integrated[5]. This presentation is designed to give an overview of the history and recent developments towards the clinical implementation of MRI guided proton therapy[6]. To date, there have been several major milestones reached. These include treatment planning optimisation, dosimetry experiments and proof of concept systems. Next generation clinical prototype systems are under construction and will aim to treat the first patients. There are still various technical challenges remaining to be addressed to realize real-time MR-integrated proton therapy. These include workflow development and artifact free real-time imaging during beam-on.

Fig 1: Progress and future challenges in MR-integrated Proton Therapy